A nationwide survey on bariatric surgery in Germany--results 2005-2007.
BACKGROUND
Most studies on bariatric surgery outcomes are performed as clinical trials or reflect the clinical experience in single centers. The status of bariatric surgery in Germany has been examined since January 1st, 2005 with the cooperation of clinics and hospitals at the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University of Magdeburg (Germany).


METHODS
In this prospective multicenter observational study, the data obtained for all primary bariatric procedures, including all repeated operations, performed on consecutive patients with morbid obesity at participating hospitals from 2005 to 2007 were prospectively collected using an Internet online data registry. In particular, perioperative characteristics, such as the spectrum of diagnostic measurements, type of surgical procedures, and short- and long-term outcomes, were investigated.


RESULTS
During the study period, 629 surgical procedures were performed at 21 hospitals in 2005, 828 procedures at 32 hospitals in 2006, and 1,666 procedures at 35 hospitals in 2007. In 2005 and 2006, gastric banding was the most frequently performed operation, followed by the Roux-en-Y gastric bypass (RYGBP). In 2007, a RYGBP was carried out in 42.1% of all bariatric procedures. Among all patients, 74.4% were female. The mean body mass index (BMI) was 48.5 kg/m(2) in 2005, 48.4 kg/m(2) in 2006, and 48.0 kg/m(2) in 2007. Follow-up data after 12 months were available for 63.8% of the patients in 2005 and 2006; these data showed greater reduction of BMI after malabsorptive rather than restrictive bariatric procedures. The mortality was 0.1% (30 days) and 0.16% (overall).


CONCLUSIONS
As indicated by the worldwide trend, there is an ongoing change from restrictive bariatric procedures to malabsorptive procedures and sleeve gastrectomy. Although the BMIs of German patients undergoing bariatric surgery appear to be substantially higher than those of patients from most other countries, there were no differences in intraoperative and short-term complications or in overall outcomes during follow-up when compared with published studies.
Stroh
Christine
C
Department of General, Abdominal and Pediatric Surgery, Municipal Hospital, Gera, Germany. Christine.Stroh@wkg.srh.de
Birk
D
D
Flade-Kuthe
R
R
Frenken
M
M
Herbig
B
B
Höhne
S
S
Köhler
H
H
Lange
V
V
Ludwig
K
K
Matkowitz
R
R
Meyer
G
G
Meyer
F
F
Pick
P
P
Horbach
T
T
Krause
S
S
Schäfer
L
L
Schlensak
M
M
Shang
E
E
Sonnenberg
T
T
Susewind
M
M
Voigt
H
H
Weiner
R
R
Wolff
S
S
Lippert
H
H
Wolf
A M
AM
Schmidt
U
U
Manger
T
T
D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality / Q000601:surgery*; D011785:Quality Assurance, Health Care; D012086:Reoperation; D016896:Treatment Outcome; D015431:Weight Loss